Suicide by Chinese rural young women is an urgent focus in suicide research, because of the high suicide rates and the large population in China. Society and culture play an enormous role in dictating how people respond to and view mental health and suicide, and studies are needed to systematically examine the role of cultural factors (e.g. the value systems) in determining risk for suicide. Psychological autopsy (PA) studies with suicides are usually limited by their indirect evaluation and understanding of the suicides' neurocognitive functions, psychiatric disorders, suicidal intent, and conflicting social values, etc. However, studying serious suicide attempters can provide direct and comparatively more reliable information on why the victims are at high risk of suicide. This project is designed to study a cultural model of suicide using serious attempters in China. Confucian values, which are considered to be the cultural foundation in Asian societies including China, are supposed to explain the high suicide risks for young women and the comparatively low risks for young men. The deep-rooted Confucian sexism coupled with the communist egalitarianism advocated in China creates frustration or strain in the daily life of some rural young women. The strain resulting from the traditional reality and modern aspiration, interacting with other risk factors, is hypothesized to increase suicide risks for Chinese rural young women. In a case-control design, 800 serious suicide attempters (400 males and 400 females) and 800 community controls (400 males and 400 females) all aged 15-34 years will be randomly sampled from 16 rural counties selected in Liaoning, Hunan, and Shandong provinces of China. The study has the following four major aims: 1. To evaluate the direct effect of risk factors from four domains (personal factors, social structure, negative life events, and psychological/psychiatric factor) on young suicide attempters in rural China. 2. To test the Strain Theory of Suicide among suicide attempters (SAs) and community controls (CCs), by examining the impact of cultural factors related to Confucian values and communist ideology on attempted suicide in rural China and the role of gender in the relationship. 3. To test the moderating or intervening effects of the risk factors on the relationship between strain and attempted suicide in rural China. 4. To examine the relationship between strain and suicide intent among the suicide attempters Findings regarding the independent role of culturally defined beliefs and values in determining suicide risk will be generalizable to other Chinese and Asian populations in the United States and elsewhere in the world. PUBLIC HEALTH RELEVANCE: Suicide is a global public health problem and suicide by Chinese rural young women is an urgent focus of research. Complementary to the traditional approaches of suicide research and prevention, this study proposes and tests a cultural model in understanding and reducing suicide. Findings regarding the independent role of culturally defined beliefs and values in determining suicide risk will be generalizable to other Chinese and Asian populations in the United States and elsewhere in the world.